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brain health ischemic cognition dementia

Gabor Fulop, Stefano Tarantini, Andriy Yabluchanskiy, Andrea Molnar, Calin Prodan, Tamas Kiss, Tamas Csipo, Agnes Lipecz, Priya Balasubramanian, Eszter Farkas, Peter Toth, Farzaneh Sorond, Anna Csiszar, Zoltan I Ungvari
There has been an increasing appreciation of role of vascular contributions to cognitive impairment and dementia (VCID) associated with old age. Strong preclinical and translational evidence links age-related dysfunction and structural alterations of the cerebral arteries, arterioles and capillaries to the pathogenesis of many types of dementia in the elderly, including Alzheimer's disease. The low pressure, low velocity and large volume venous circulation of the brain also plays critical roles in the maintenance of homeostasis in the central nervous system...
March 8, 2019: American Journal of Physiology. Heart and Circulatory Physiology
Vincent Chin-Hung Chen, Shu-I Wu, Kuo-You Huang, Yao-Hsu Yang, Ting-Yu Kuo, Hsin-Yi Liang, Kuan-Lun Huang, Michael Gossop
OBJECTIVE: Some infectious diseases have been found to be associated with cognitive impairment and dementia. However, the relationship between herpes zoster and dementia has received little attention. This study aimed to investigate this association as well as associations of antiviral treatments for herpes zoster and incident dementia using a large national sample. METHODS: Cases were identified from the Taiwan National Health Insurance Research Database with a new diagnosis of herpes zoster (ICD-9-CM code: 053) between 1997 and 2013...
January 2018: Journal of Clinical Psychiatry
Min-Sun Kwak, Kyung Won Kim, Hyobin Seo, Goh-Eun Chung, Jeong Yoon Yim, Donghee Kim
BACKGROUND/AIMS: Lacunar infarct, a small subcortical ischaemic lesion, is a known risk factor for future cognitive impairment, dementia and stroke. We evaluated the relationship between fatty liver disease (FLD) and lacunar infarct in a healthy general population. METHODS: Subjects who underwent brain magnetic resonance imaging (MRI) and abdominal ultrasonography (US) during health check-ups from 2007 to 2009 were included. FLD was diagnosed by US. Subjects with a history of cerebrovascular disease, radiological findings consistent with cerebrovascular stenosis or cerebral small vessel disease were excluded...
July 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Lena Rivard, Paul Khairy
Atrial fibrillation (AF) and dementia are major health issues, with growing evidence suggesting a consistent association between AF and all forms of dementia. Although dementia and AF share several risk factors, the association appears to be independent of a history of clinical stroke and other comorbidities such as hypertension, heart failure, and diabetes. Proposed mechanisms linking AF to cognitive decline include altered hemodynamics resulting in cerebral hypoperfusion, inflammation, genetic factors, and silent cerebral ischemia due to subclinical microemboli...
December 2017: Canadian Journal of Cardiology
Rafał Badacz, Anna Kabłak-Ziembicka, Małgorzata Urbańczyk-Zawadzka, Robert P Banyś, Piotr Musiałek, Piotr Odrowąż-Pieniążek, Mariusz Trystuła, Jan Ścigalski, Krzysztof Żmudka, Tadeusz Przewłocki
INTRODUCTION: About 30% of patients with carotid artery stenosis (CAS) develop dementia after a cerebral ischemic event (CIE), and 20-50% suffer from CIE recurrence during 6 months. Carotid artery revascularization (CAR) may prevent CIE recurrence, at the cost of new microembolic lesions (MES). The impact of CAR on cognitive function is debatable. AIM: To assess functional and cognitive outcome, cerebral flow on transcranial Doppler (TCD) and brain magnetic resonance imaging (MRI) in patients with symptomatic CAS referred for CAR...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Gary A Rosenberg
Vascular cognitive impairment and dementia (VCID) is a major public health concern because of the increased incidence of vascular disease in the aging population and the impact of vascular disease on Alzheimer's disease. VCID is a heterogeneous group of diseases for which there are no proven treatments. Biomarkers can be used to select more homogeneous populations. Small vessel disease is the most prevalent form of VCID and is the optimal form for treatment trials because there is a progressive course with characteristic pathological changes...
March 2018: Journal of Neurochemistry
Peter Toth, Stefano Tarantini, Anna Csiszar, Zoltan Ungvari
Increasing evidence from epidemiological, clinical and experimental studies indicate that age-related cerebromicrovascular dysfunction and microcirculatory damage play critical roles in the pathogenesis of many types of dementia in the elderly, including Alzheimer's disease. Understanding and targeting the age-related pathophysiological mechanisms that underlie vascular contributions to cognitive impairment and dementia (VCID) are expected to have a major role in preserving brain health in older individuals...
January 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
Marie-germaine Bousser
Despite a decrease in stroke mortality, the global burden of stroke is increasing worldwide, hence the importance of improving prevention, acute treatment and rehabilitation. Nume- rous randomized clinical trials have been performed in the acute treatment of the three main varieties of stroke, namely acute cerebral ischemia, intracerebral hemorrhage and suba- rachnoid hemorrhage. They have all shown that " time is brain ". Stroke, however, is only the tip of the iceberg: MRI studies have shown the frequency of silent ischemic and hemorrhagic lesions contributing to cognitive impairment and eventually to dementia...
November 2014: Bulletin de L'Académie Nationale de Médecine
Ira Driscoll, Sarah A Gaussoin, Sylvia Wassertheil-Smoller, Marian Limacher, Ramon Casanova, Kristine Yaffe, Susan M Resnick, Mark A Espeland
BACKGROUND: Midlife obesity has been linked to age-related brain atrophy and risk of dementia, but the relationships are less clear for older individuals. These associations may be explained by changes in appetite or metabolism in the dementia prodrome; thus, prospective studies with adequate follow-up are needed. We examined the associations that obesity (body mass index, BMI) and change in BMI over an average of 6.6 (1.0-9.1) years have with global and regional brain and white matter lesion volumes in a sample of 1,366 women aged 65-80...
March 9, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Pushpendra Nath Renjen, Charu Gauba, Dinesh Chaudhari
BACKGROUND: Vascular dementia is extremely common and contributes to stroke-associated morbidity and mortality. The study of vascular dementia may help to plan preventive interventions. AIMS: To study the frequency of cognitive impairment after stroke in a series of consecutive patients with acute stroke, along with factors which influence it. METHODS: Fifty adults with acute infarct or hemorrhage (as seen on computed tomography of the brain) were included in the study...
2015: Curēus
Mohammad Badruzzaman Khan, Md Nasrul Hoda, Kumar Vaibhav, Shailendra Giri, Philip Wang, Jennifer L Waller, Adviye Ergul, Krishnan M Dhandapani, Susan C Fagan, David C Hess
We previously reported that remote limb ischemic conditioning (RLIC; PERconditioning) during acute stroke confers neuroprotection, possibly due to increased cerebral blood flow (CBF). Vascular cognitive impairment (VCI) is a growing threat to public health without any known treatment. The bilateral common carotid artery stenosis (BCAS) mouse model is regarded as the most valid model for VCI. We hypothesized that RLIC (postconditioning; RIPostC) will augment CBF during chronic cerebral hypoperfusion (CCH) and prevent cognitive impairment in the BCAS model...
February 2015: Translational Stroke Research
Sylvia Wassertheil-Smoller, Robert C Kaplan, Christian R Salazar
The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest...
November 2014: Seminars in Reproductive Medicine
Christina L Nemeth, Ebrahim Haroon, Gretchen N Neigh
BACKGROUND: Cerebromicrovascular disease (CMVD) strikes 87% of the population older than 65 years and is linked to an increased risk of ischemic stroke, depression, cognitive impairment, and Alzheimer's disease. Despite the wealth of knowledge on the consequences to the body stemming from poor vascular health, little focus has been placed on the consequences to the brain. DESIGN: In this review, we present the preclinical and clinical evidence that supports the role of CMVD in behavioral dysfunction, argues for a clinical need for better recognition of the vascular depression phenotype, and calls for a more integrative translational approach to CMVD...
June 2014: International Journal of Geriatric Psychiatry
Zainab S Bahrainwala, Argye E Hillis, Jennifer Dearborn, Rebecca F Gottesman
BACKGROUND: Leukoaraiosis and its progression have longitudinally been associated with cognitive decline and dementia. Its role in acute cognitive function and response to acute cerebral ischemia is less well understood. We evaluated whether the presence and extent of leukoaraiosis, or white matter hyperintensities (WMH), had an impact on performance on tests of hemispatial neglect in acute ischemic stroke patients. METHODS: A series of 206 acute ischemic right-hemispheric stroke patients at Johns Hopkins Hospital underwent brain MRI and cognitive assessment for hemispatial neglect within 5 days of symptom onset...
2014: Cerebrovascular Diseases
Lynda D Lisabeth, Brisa N Sánchez, Jonggyu Baek, Lesli E Skolarus, Melinda A Smith, Nelda Garcia, Devin L Brown, Lewis B Morgenstern
BACKGROUND AND PURPOSE: Our objective was to compare neurological, functional, and cognitive stroke outcomes in Mexican Americans (MAs) and non-Hispanic whites using data from a population-based study. METHODS: Ischemic strokes (2008-2012) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project. Data were collected from patient or proxy interviews (conducted at baseline and 90 days poststroke) and medical records. Ethnic differences in neurological (National Institutes of Health Stroke Scale: range, 0-44; higher scores worse), functional (activities of daily living/instrumental activities of daily living score: range, 1-4; higher scores worse), and cognitive (Modified Mini-Mental State Examination: range, 0-100; lower scores worse) outcomes were assessed with Tobit or linear regression adjusted for demographics and clinical factors...
April 2014: Stroke; a Journal of Cerebral Circulation
Stephen R Rapp, Mark A Espeland, Joann E Manson, Susan M Resnick, Nick R Bryan, Sylvia Smoller, Laura H Coker, Lawrence S Phillips, Marcia L Stefanick, Gloria E Sarto
The relationship between neuropathology and clinically manifested functional and cognitive deficits is complex. Clinical observations of individuals with greater neuropathology who function better than some individuals with less neuropathology are common and puzzling. Educational attainment, a proxy for "cognitive reserve," may help to explain this apparent contradiction. The objective of this study is to determine if educational attainment is correlated with cognitive decline, brain lesion volume, and total brain atrophy...
2013: International Journal of Psychiatry in Medicine
Solveig Horstmann, Timolaos Rizos, Geraldine Rauch, Maximilian Fuchs, Cathrin Arden, Roland Veltkamp
Dementia and atrial fibrillation (AF) are common comorbidities in stroke patients. The potential role of AF in cognitive impairment prior to a first stroke has yet not been characterized. The aim of our study was to evaluate the prevalence of prestroke cognitive impairment in stroke patients, and to identify whether AF is associated with prestroke cognitive impairment. In this prospective, single-center, explorative, observational study, consecutive patients with first ever transient ischemic attack (TIA), ischemic (IS) or hemorrhagic stroke (ICH) were included...
March 2014: Journal of Neurology
Myung-Jin Cha, Hyo Eun Park, Min-Ho Lee, Youngjin Cho, Eue-Keun Choi, Seil Oh
Varied silent ischemic stroke (SS) prevalence occurs in patients with atrial fibrillation (AF). Stroke history is worth 2 points in the CHADS2 scoring system. An unknown proportion of patients with AF with a CHADS2 score of 0 or 1 have been undertreated for stroke prevention. We investigated SS risk factors using magnetic resonance imaging and estimated SS impact on clinical outcomes in patients with AF. We analyzed a total of 1,200 patients (400 with AF and 800 with sinus rhythm) who had brain magnetic resonance imaging performed for routine health checkups...
February 15, 2014: American Journal of Cardiology
Lin Shi, Defeng Wang, Winnie C W Chu, Shangping Liu, Yunyun Xiong, Yilong Wang, Yongjun Wang, Lawrence K S Wong, Vincent C T Mok
Structural changes after ischemic stroke could affect information communication extensively in the brain network. It is likely that the defects in the white matter (WM) network play a key role in information interchange. In this study, we used graph theoretical analysis to examine potential organization alteration in the WM network architecture derived from diffusion tensor images from subjects with no dementia and experienced stroke in the past 5.4-14.8 months (N = 47, Mini-Mental Screening Examination, MMSE range 18-30), compared with a normal control group with 44 age and gender-matched healthy volunteers (MMSE range 26-30)...
2013: PloS One
Qiuyun Tu, Binrong Ding, Xia Yang, Song Bai, Junshi Tu, Xiao Liu, Ranran Wang, Jinghua Tao, Hui Jin, Yiqun Wang, Xiangqi Tang
The objectives of the study were to explore the prevalence and effects of vascular cognitive impairment (VCI) among ischemic stroke patients and to provide a basis for prevention and treatment strategies. A stratified cluster random sampling method was performed, and 689 ischemic stroke patients (over 40 years of age) were enrolled. All of the patients had received a neuropsychological assessment battery to assess cognitive function and self-designed questionnaires to collect relevant information. According to the cognitive status, the patients were divided into two groups, a case group and a control group...
March 2014: Archives of Gerontology and Geriatrics
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